Trends: Augmenting Treatment With Medical Foods

To put those figures in perspective, Orndorff points out that the typical patient with mild to moderate Alzheimer’s disease will demonstrate a decline of 5 to 10 points a year, on average, on those same cognitive function tests. “So with a seven-point improvement, you’re looking at delaying that disease by a whole year,” he says.

While no specific data are available yet, Axona also appears to prevent other types of early age-related memory loss, Orndorff says.

Accera currently is reaching out to clinicians across the country to educate them about their product. More information is available in the provider section of their Web site, www.accerapharma.com.

“It Really Does Help” Memory Impairment
Meanwhile, clinicians with large populations of elderly patients are seeing good results with another medical food product from Pamlab, called Cerefolin^®. It is designed to help patients combat the forgetfulness typically associated with aging (also known as age-associated memory impairment). Like Deplin, Cerefolin contains high doses of folate, in a form that is easier for the body to metabolize.

Bennett Machanic, MD, a neurologist and associate clinical professor at the University of Colorado, turned to medical foods, in part, because he was not happy with the choice of conventional drugs on the market for patients with premature memory loss. “At best, there is a modest benefit from those medicines, but they are not cures,” he says.

Machanic typically tries Cere-folin for any patient who comes in with an elevated level of homocysteine. “I figure at the very worst, it’s harmless, and at the very best, it may improve memory, cognition, and behavior,” Machanic says. “Families are telling me it really does help.”

Word is spreading slowly through the medical community, Machanic says. But once clinicians learn about medical foods like Cerefolin, they are convinced, he adds. “There are physicians across the country who are taking it themselves” to slow memory loss, he says. “Many of these people feel they can prevent Alzheimer’s by taking this (although there is no shred of evidence to prove it). They just feel they are mentally sharper when they take it.”

For details on Cerefolin dosages and prescribing, visit www.pamlabs.com.

“The Perfect Drugs” for Neuropathy?
Diabetic neuropathy is another area in which medical foods can offer patients some new hope. Studies show they can also cut costs by reducing the need for pricey conventional treatments.

Diabetic neuropathy can be very dangerous for diabetic patients because they lose sensation in their feet and legs. Falls become increasingly common, and if they step on a nail, they might not feel the warning signals of pain and the wound can become infected. Too often, that leads patients to lose a toe or an entire limb.

Like Machanic, Dorothy Merritt, MD, an internal medicine provider in Texas City, Texas, turned to medical foods out of frustration. Merritt says her practice has a high percentage of diabetic patients, many with neuropathy. While most clinicians treat this painful condition with antiseizure drugs, the conventional treatments are not very effective, Merritt says. They also have many troublesome adverse effects. “They cause a lot of sedation,” she adds.

Merritt confesses she was aware of medical foods for two years before she started prescribing them. “I let them sit on the shelf,” she says.

But when she read an NIH article about the gene MTHSR, she realized nearly half of all Americans have a genetic inability to process the folate in the foods they eat. Even if they take vitamins like B12 and folic acid, their bodies cannot convert these substances into a
usable form, Merritt explains. “This gene is easy to test for, and 90% of the people in my practice have it,” she says.

Medical foods like Metanx^® (another product from Pamlab) and Cerefolin offer folate in a more bioavailable form that the body can use, even if the patient has this genetic defect. Metanx, in particular, has been shown to be effective in reducing the pain and numbness associated with diabetic neuropathy. “Metanx restores their nervous system,” Merritt says.

Medical foods have dramatically changed the way Merritt practices medicine. She jokes that her drug reps thought she had retired because she and the two PAs on her staff are now writing about half as many prescriptions for conventional drugs as they once were.

“I like these medical foods because they get down to heal the basis of what is making people ill (instead of masking the symptoms),” Merritt says, adding that these agents seem to have very few adverse effects. “From a clinical point of view, they are the perfect drugs.”